VA-FSC VENDOR FILE REQUEST FORM 10091

Forms and Documents

Document	Type	Status	Availability
Form VA Form 10091 VA-FSC VENDOR FILE REQUEST FORM 10091	Form and Instruction	New	Repair queued
White Paper for FCS VA Vendor form 10091_vhr.docx	Supplementary Document	Uploaded 2016-05-04	Repair queued
30-day FRN Vendor File ReqFrm 10091_2016-03401.pdf	Supplementary Document	Uploaded 2016-04-29	Available
FEDREG_VendorFileReqForm_2015-30288.pdf	Supplementary Document	Uploaded 2016-04-29	Repair queued
SS_VA10091_VA-FSC VendorFile Req_02May16_vhr.docx	Supporting Statement A	Uploaded 2016-05-04	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
221305	VA-FSC VENDOR FILE REQUEST FORM 10091	Form and Instruction	New

ICR Details

OMB Control No: 2900-0846	ICR Reference No: 201604-2900-021
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: VA	Agency Tracking No:
Title: VA-FSC VENDOR FILE REQUEST FORM 10091
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/19/2016
	Date Received in OIRA: 05/04/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2019	36 Months From Approved
Responses	150,000	0	0
Time Burden (Hours)	37,500	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The mission of the Nationwide Vendor File Division of the Department of Veterans Affairs – Financial Services Center (VA-FSC) is to add, modify, or delete vendor records in the Financial Management Services (FMS) Vendor File. The VA-FSCs FMS Vendor File controls aspects of when, where, and how vendors are paid. There are currently more than 2.4M active vendor records in FMS. The new Vendorizing Form (VA10091) streamlines the data required to establish a vendor record (from the SF 3881 and Vendorizing Cover Sheet) into a single form. By the summer of 2014, the VA-FSC began utilizing the VA10091 for Vendorizing purposes. VA seeks to have this data collection become fully compliant under the guidelines of the PRA.

---

Authorizing Statute(s): PL: Pub.L. 104 - 134 31001 Name of Law: Debt Collection Improvement Act of 1996
   US Code: 31 USC 3701 Name of Law: Debt Collection Improvement Act of 1996
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 74837	11/30/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 8594	02/19/2016
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
VA-FSC VENDOR FILE REQUEST FORM 10091	VA Form 10091	VA-FSC VENDOR FILE REQUEST FORM

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	150,000	0	0	150,000	0	0
Annual Time Burden (Hours)	37,500	0	0	37,500	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new data collection request. All burden hours are considered an increase.

---

Annual Cost to Federal Government: $161,175

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/04/2016

---